Do You Have the Courage to Change?

Why is it so hard to change old habits and set patterns even when they’re bad for us? Whether it’s smoking or drinking to “manage” stress, or eating junk food because it’s easier than cooking, psychologist and author Walter J. Urban, PhD, says it takes guts to face the reasons we resist changing. His recent book, Do You Have the Courage to Change? The 12 Basic Reasons Why People Don’t Change and How You Can (available from 1stBooks Library, 2004), discusses the reasons in easy-to-understand language that ranges from the Old Shoe to Too Hard and Busy, Busy, Busy. He recently spoke with EMS Magazine’s Assistant Editor, Kathryn Robyn, about steps people can take to support their decision to change.

EMS: Why don’t people change bad habits?

Urban: The first thing is not to label them as bad. Habits are formed for various reasons, so instead of judging ourselves negatively, let’s just call them habits. The second thing is to bring these habits into your consciousness. Many times a habit becomes so ingrained, so automatic, that people are unaware of how it’s operating. Repetition strengthens the habit and as the habit gets stronger and stronger, it becomes very difficult to change. People start defending the habit; they need to protect it because they are used to it, used to living with that particular situation, condition, food or whatever it may be and they don’t want to be interfered with, because they think it’s part of them.

EMS: Does becoming aware of the reason you have a habit put you in a position to make a conscious choice?

Urban: It’s not so easy to simply make a rational choice. There are millions of people who smoke cigarettes—and they are aware of the fact that they are creating health hazards and possibilities of cancer—yet they don’t make a rational choice.

EMS: So what else do they need?

Urban: They need the motivation to change. And they need to have the proper attitude. Without motivation, they’re not going to do anything. And if their attitude is negative, they’re not even going to listen or allow the facts to enter their system of reasoning. That’s why people often wait for a crisis to change. There are people who say, “My great uncle lived to 93 and he smoked every day.” Well, a classic thing is to believe you’re all-powerful, but that guy was a real exception to the rule. So, you need to be able to absorb the facts, put them into your emotional life, into your mentality, not just simply read the statistics.

EMS: Let’s say there’s a medic who’s in the habit of managing his stress with junk food, tobacco and alcohol. What can he do to change any of that?

Urban: He needs to become aware that he’s doing that, first of all. Then find out his motivation to change it, because how we work inside is the key to how we work outside. It all starts with our selves. The steps to change are: self-observation, self-acceptance, evaluation of the current situation, assessment that the new goals are desired, setting of limited goals to achieve success, the acceptance of the gradualness of change, continued effort and joy of the process; and the last step is allowing for regressions. That is, if you slip back, don’t get down on yourself, just get back on track and keep working. But never consider yourself to be bad.

EMS: Okay, so he’s conscious of it, he’s motivated, and he’s working on his attitude. But he’s stressed. What does he do?

Urban: You brought up food—that’s the “original satisfier” or pacifier for human beings. The first thing you get is food and caring from the mothering figure, so when you’re under stress, you revert back to the state of wanting to calm yourself. Later, it becomes smoking and drinking, but it’s the same thing. So, he can learn to become conscious of this automatic mechanism to reach for the pacifier.

The next step is to build a state of tolerance before acting on the impulse to indulge. For example, someone who wants to stop smoking—they get the urge to smoke, but count to 50 before lighting up instead. They’re building a 50-second tolerance. Then they raise it to 100 and so on, increasing their emotional capacity to deal with the unpleasant feeling by slowly increasing their tolerance. That puts you in charge, rather than the automatic mechanism. A whole class should be designed to teach EMS workers to manage and handle stress—and that’s where they would also learn to look into their own personal makeup; their own emotional life. Because you cannot separate the degree of stress you feel from your personal makeup. So it would help them learn how to look at themselves, how they react to stress and what they automatically do when they feel the stress; and then it would have to help them learn how to successfully face their own personal traits and then, step-by-step, change them.

EMS: Is that the part that takes courage—looking at yourself?

Urban: Yes, but if you start with self-acceptance, it’s not so scary. Self-love makes it easy. And not just a little bit of it, a lot of it.